PD45-07 PROSPECTIVE COMPARISON OF FUNCTIONAL OUTCOMES AFTER ENDOSCOPIC SURGICAL INTERVENTIONS FOR BENIGN PROSTATIC HYPERPLASIA: THE ROLE OF EJACULATION-SPARING ANATOMIC PHOTOSELECTIVE VAPORIZATION OF THE PROSTATE (ESA-PVP)

Abstract

You have accessJournal of UrologyCME1 May 2022PD45-07 PROSPECTIVE COMPARISON OF FUNCTIONAL OUTCOMES AFTER ENDOSCOPIC SURGICAL INTERVENTIONS FOR BENIGN PROSTATIC HYPERPLASIA: THE ROLE OF EJACULATION-SPARING ANATOMIC PHOTOSELECTIVE VAPORIZATION OF THE PROSTATE (ESA-PVP) Mattia Sibona, Paolo Destefanis, Federico Vitiello, Eugenia Vercelli, Gabriele Montefusco, Alessandro Mara, Andrea Bosio, Alessandro Bisconti, and Paolo Gontero Mattia SibonaMattia Sibona More articles by this author , Paolo DestefanisPaolo Destefanis More articles by this author , Federico VitielloFederico Vitiello More articles by this author , Eugenia VercelliEugenia Vercelli More articles by this author , Gabriele MontefuscoGabriele Montefusco More articles by this author , Alessandro MaraAlessandro Mara More articles by this author , Andrea BosioAndrea Bosio More articles by this author , Alessandro BiscontiAlessandro Bisconti More articles by this author , and Paolo GonteroPaolo Gontero More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002613.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ejaculatory Dysfunction (EjD) is still a common event after Benign Prostatic Hyperplasia (BPH) surgery, causing significant bother to younger and sexually active patients (pts). Recently, several ejaculation-sparing techniques were described. Ejaculation-sparing anatomic Photoselective Vaporization of the Prostate (ESa-PVP) with LBO laser has been proposed as a sexual function-sparing evolution of the anatomic PVP technique, showing promising preliminary results. The aim of our study was to present a prospective comparison of functional outcomes from a cohort of ESa-PVP pts versus standard PVP and Transurethral Resection of the Prostate (TUR-P). METHODS: Local Ethics Committee approval was obtained (n. 643/2018). Our study was conceived as a prospective, observational analysis. From 03/2018 to 06/2020, we enrolled pts undergoing endoscopic surgery for BPH at our institution (Molinette Hospital, Turin). Inclusion criteria: age > 50, sexually active, moderate to severe Lower Urinary Tract Symptoms (LUTS) [IPSS > 8]. Urinary and sexual function data were collected at baseline and at 6 and 12 month after surgery. Validated questionnaires were used to assess functional results (IPSS, IIEF5, MSHQ-Ej). Included pts were divided into groups, according to the type of intervention: bipolar TUR-P (group A); standard PVP (group B); ESa-PVP (group C). RESULTS: Globally, 95 pts were included (46 in group A, 26 in group B, 23 in group C). Median (IQR) age was 66 (60-71) years. Median prostate volume was 63 (50-90) cc. Median baseline IPSS score within groups was 25 vs 24.5 vs 28 (p=0.442); median IIEF-5 score was 21 vs 23.5 vs 20 (p=0.339); median MSHQ-Ej score was 30 vs 33.5 vs 34 (p=0.137). Baseline antegrade ejaculation rate was 84.78% vs 80.77% vs 91.30% (p=0.579). At 6-month follow-up, urinary and sexual function scores changed as follows: median IPSS: 6 vs 5 vs 1 (p=0.019); median IIEF5: 21 vs 21.5 vs 19 (p=0.750); median MSHQ-Ej: 4 vs 2 vs 15 (p=0.001). 6-month antegrade ejaculation rate was 28.89% vs 23.08% vs 60.87% (p=0.010). 12 months after surgery, no significant differences in IPSS and IIEF5 scores were detected within groups. Instead, median MSHQ-Ej score was 2 vs 2 vs 25 (p=0.006) and antegrade ejaculation rate was 26.09% vs 13.04% vs 58.82% (p=0.007). At a multivariable logistic regression analysis, pre-operative MSHQ-Ej score was identified as an independent predictor of antegrade ejaculation preservation both at 6 and 12 months, while surgical technique appeared as a significant predictor of the same outcome at 6 months. CONCLUSIONS: The Ejaculation-Sparing anatomic PVP technique (ESa-PVP) showed superiority over standard PVP and TUR-P in preserving antegrade ejaculation both at 6 and 12 month follow-up after BPH surgery. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e785 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mattia Sibona More articles by this author Paolo Destefanis More articles by this author Federico Vitiello More articles by this author Eugenia Vercelli More articles by this author Gabriele Montefusco More articles by this author Alessandro Mara More articles by this author Andrea Bosio More articles by this author Alessandro Bisconti More articles by this author Paolo Gontero More articles by this author Expand All Advertisement PDF DownloadLoading ...